A paper that changed my practice, twice

BMJ 2002; 325 doi: (Published 23 November 2002) Cite this as: BMJ 2002;325:1240
  1. Alex Clark, senior house officer in general medicine (
  1. Royal Preston Hospital

    As a newly qualified preregistration house officer, alone on an orthopaedic ward one weekend, I was asked to review a patient complaining of pleuritic chest pain. This meant considering a short list of differential diagnoses to treat or exclude. Among these, of course, was pulmonary embolism, hence a D-dimer test seemed relevant. I can't remember much about this specific encounter, but I know I thought, worried, and procrastinated for as long as it took for the blood results to come back. Then I bleeped the medical registrar to ask what to do about the abnormal D-dimer test result.

    The most memorable part of the encounter was …

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